BACKGROUND: According as old aged people have an increased interest in early detection of disease and health promotion, old aged people who take health examinations are increased. So this study is aimed to survey common problems about geriatric health in community and their frequency by way of investigation on diagnosis in health examination data and to evaluate the effects of health risk factors on each disease patterns. METHODS: The medical records of the clients who have taken health examinations for the first time from March 1995 to February 2000 at a health examination center of a university hospital in Seoul were reviewed. The category and number of judged diagnosis, sociodemographic factors are compared and analyzed. RESULTS: The selected medical records accounted to 22,393. The study subjects consist of 11,544(51.6%) male. Mean age is 52.0+/-10.5 years(range 16~90). 65 years or more old aged people of them are 2,612(11.7%), the number of judged diagnosis per one old person is 4.84+/-2.22(range 0~9) and young people took less diagnosis is 35.7%, functional diagnosis is 7.9%. The common diagnoses are liver disease(7.07%), decreased physical strength(6.68%), hyperlipidemin(6.53%),obesity(5.90%), osteoporosis or postmenopausal syndrome(4.72%), need for immunization against viral hepatitis(4.69%), hypertension(4.20%) functional gastrointestinal disease(3.93%). The number of total diagnosis and organic diagnosis is larger in older age, no exercise, female,smoker, no-spouse, lower education(p<0.05). The number of other diagnosis is larger in no exercise, smoker, female, younger age(p<0.05). CONCLUSION: According to health examination, total diagnosis and organic diagnosis are more in old aged group than in young. Functioinal diagnosis and other diagnosis is less in old aged group than in young.
Diagnosis* ; Early Diagnosis ; Female ; Health Promotion ; Humans ; Immunization ; Liver ; Male ; Medical Records ; Osteoporosis ; Risk Factors ; Seoul

The purpose of this study was to compare the microleakage of the composite resin cores according to surface treatment, dentin bonding agents, and thermocycling. For this study, 120 extracted premolar teeth were used. Flat occlusal surfaces were prepared with diamond disk, and treated with air-abrasion, acid-etching, combination. The composite resin core was built with Z-100 after application of Scotchbond Multi-Purpose and All-Bond 2. Prepared specimens were thermocycled for 2,000 cycles. Specimens were immersed in 1% methylene blue solution for 24hours at 371C. The microleakage was measured with a inverted metallurgical microscope(BHS313, Olympus, Japan). The following conclusions were drawn from this study 1. The microleakages in the groups treated with air-abrasion and with acid etching were greater than that of the groups treated with combination method before thermocycling(p<0.05), the microleakages of the groups treated with air-abrasion were greater than that of the groups treated with acid-etching and combination method after thermocycling(p<0.05). 2. There were no significant difference between groups using Scotchbond Multi-Purpose and the groups using All-Bond 2. 3. Thermocycling didri t affect the change of microleakage in all cases.
Bicuspid ; Dentin-Bonding Agents ; Diamond ; Methylene Blue ; Tooth

The purpose of this study was to compare the microleakage of the composite resin cores according to surface treatment, dentin bonding agents, and thermocycling. For this study, 120 extracted premolar teeth were used. Flat occlusal surfaces were prepared with diamond disk, and treated with air-abrasion, acid-etching, combination. The composite resin core was built with Z-100 after application of Scotchbond Multi-Purpose and All-Bond 2. Prepared specimens were thermocycled for 2,000 cycles. Specimens were immersed in 1% methylene blue solution for 24hours at 371C. The microleakage was measured with a inverted metallurgical microscope(BHS313, Olympus, Japan). The following conclusions were drawn from this study 1. The microleakages in the groups treated with air-abrasion and with acid etching were greater than that of the groups treated with combination method before thermocycling(p<0.05), the microleakages of the groups treated with air-abrasion were greater than that of the groups treated with acid-etching and combination method after thermocycling(p<0.05). 2. There were no significant difference between groups using Scotchbond Multi-Purpose and the groups using All-Bond 2. 3. Thermocycling didri t affect the change of microleakage in all cases.
Bicuspid ; Dentin-Bonding Agents ; Diamond ; Methylene Blue ; Tooth

We report a case of clinical features corresponding to Eosinophilia-Myalgia syndrome, with no causal relationship with L-tryptophan. Since the epidemic of L-tryptophan associated Eosinoghilia-Myalgia Syndrome in 1989, only 2% of the cases were found not to be related to L-tryptophan in America. We believe that this is the first case report of Eosinophilin-Myalgia Syndrome not related to L-tryptophan in Korea.
Americas ; Electrodiagnosis ; Eosinophilia-Myalgia Syndrome* ; Korea ; Tryptophan*

OBJECTIVE: To identify the existence of ipsilateral responses by magnetic stimulation, and to elucidate the influences of ipsilateral tonic contraction on bilateral MEP responses, and to attain the proper facilitation technique for bilateral MEP responses. METHOD: Ten normal healthy volunteers who were right handed, were recruited. They performed the voluntary contraction of thenar muscle via lateral prehension with three stage, contralateral, bilateral, ipsilateral contraction by 70 mm bipolar coil stimulator (figure-of-eight shaped). The excitability threshold (ET) at rest was determined, and then, three facilitation techniques with combination of both voluntary contraction and stimulus intensity were also performed: A technique, minimal facilitation (10% of MVC) with ET intensity; B technique, moderate facilitation (30% of MVC) with 110% of ET intensity; C technique, minimal facilitation (10% of MVC) with 140% of ET intensity. Contralateral, bilateral and ipsilateral voluntary contractions were performed in each technique. In 90 mm circular coil stimulator, same procedure as above was followed. RESULTS: There were no differences of ET between the two coil stimulators. Ipsilateral MEP responses were not detected after bipolar coil stimulation except one case in C technique, but they were developed over 70% in B and C technique with ipsilateral muscle contraction. However, only 2 cases of ipsilateal responses could be detected in C technique, and not detected in A and B technique. The latency of ipsilateral responses were similar to that of contralateral responses, but the amplitude was much lower than that of contralateral responses. Ipsilateral muscle contraction reduced the amplitude of contralateral MEP in moderate facilitation (B technique). Especially, ipsilateral response was never evoked in B technique with contralateral contraction. CONCLUSION: In normal subjects, ipsilateral MEPs can't be obtained in focal magnetic stimulation. Ipsilateral tonic contractions are regarded as reducing facilitative effects of contralateral MEP responses. Bilateral responses should be attained when contralateral target muscle is contracted with moderate facilitation (30% of MVC and 110% of threshold intensity). In this facilitation, the stimulation by circular coil is no less effective than focal stimulation by 70 mm bipolar.
Evoked Potentials, Motor* ; Hand ; Healthy Volunteers ; Muscle Contraction ; Transcranial Magnetic Stimulation*

OBJECTIVES: To analyze the motor evoked potential (MEP) responses to a degree of voluntary contraction and stimulus intensity and to suggest the standardized optimal stimulation for MEP responses. METHODS: MEPs induced by a cortical stimulation were elicited at the thenar muscles in 15 normal subjects during the rest and gradual voluntary contraction, using the 10% of maximal voluntary contraction (MVC), 30%, 50%, and MVC. During rest and during each contraction, excitability threshold at rest (RET) and at contraction (CET) were determined. Consecutive stimuli were applied, according to the intensity of ratio increment (110% to 150% of excitation threshold). RESULTS: The RET showed a remarkable decrease (57.1+/-8.2% --> 47.4+/-8.7%) after the voluntary contraction (P<0.05). Shortening of latency reached the saturation level with 10% of MVC, irrespective of stimulus intensity. Amplitude reached a saturation level at 30% of MVC with 62.7% intensity of maximal output, which is equal to 140% intensity of its CET, and to 110% of RET. MEP amplitude at rest and at 10% of MVC were influenced by the excitation threshold (P<0.05), but those at above 30% of MVC were not related. CONCLUSION: The procedure for optimal facilitation for the MEPs is as follows; for minimal latency of MEPs, minimal contraction (10% of MVC) with RET intensity is enough. For maximal amplitude of MEPs, moderate contraction (30% MVC) with 110% intensity of RET is adequate.
Evoked Potentials, Motor ; Muscles ; Transcranial Magnetic Stimulation*

OBJECTIVE: Immobility in stroke patients increases the risk of thromboembolism, and the pulmonary embolism following deep vein thrombosis (DVT) may lead to life-threatening state. But in Korea there has been a few studies about DVT in rehabilitation patients. So we investigated the prevalence of DVT in hemiplegic patients and the characteristics of the risk factors in these patients. METHOD: Ninety six rehabilitation inpatients with hemiplegia due to brain disease were participated and they had more than 2 scores in pretest probabilities. Muscle power and spasticity of hemiplegic lower limb were assessed. The duration of bed-ridden state and the presence of hypertension, diabetes mellitus and heart disease were evaluated and coagulation factors were also evaluated. Duplex ultrasound and venography were used for diagnosis of DVT, and perfusion scan for pulmonary embolism. RESULTS: Four patients among ninety six (4.17%) were diagnosed as DVT. In patients with DVT, the weaker muscle power and the longer bed-ridden duration were found. CONCLUSION: Prevalence of DVT in hemiplegic patients was 4.17%. The paresis of lower limb and long bed-ridden duration were suggested as risk factors of DVT in hemiplegic patients in Korea.
Blood Coagulation Factors ; Brain Diseases ; Diabetes Mellitus ; Diagnosis ; Heart Diseases ; Hemiplegia ; Humans ; Hypertension ; Inpatients* ; Korea ; Lower Extremity ; Muscle Spasticity ; Paresis ; Perfusion ; Phlebography ; Prevalence ; Pulmonary Embolism ; Rehabilitation* ; Risk Factors ; Stroke ; Thromboembolism ; Ultrasonography ; Venous Thrombosis*

OBJECTIVES: This study was designed to measure sympathetic skin responses (SSRs) following magnetic stimulation of the cervicothoracic spine and to evaluate its clinical usefulness. METHODS: Fifteen healthy volunteers who had no dysautonomic symptoms or signs and a patient with C6 spinal cord transection participated in this study. To evoke SSR, we stimulated the C7 spinous process (SP) and T2 SP with 90 mm circular coil (Magstim 200). We recorded the sensory nerve action potential (SNAP) from the right middle finger to ascertain whether the C7 dorsal root was depolarized by the C7 SP stimulation. The same stimulation intensity by which SNAP had been obtained was used to evoke the SSR by the C7 and T2 SP stimulation. The recording of SSR was done in both palms. SNAP was recorded by the magnetic stimulation on the C7 SP in all subjects. RESULTS: By the C7 SP stimulation, the latency of SSR was 1.35 sec in the right palm, 1.33 sec in the left palm and by the T2 SP stimulation, the latency was 1.24 sec, 1.23 sec in order. The right-left difference was not found by each SP stimulation, but the latency of SSR by the T2 SP stimulation was faster than that by the C7 SP stimulation (p<0.01). The latency difference of C7 and T2 SP stimulation was 0.11 sec in the right palm, 0.10 sec in the left palm. In a case of C6 cord transection, SSR was evoked neither by the right median electric stimulation, nor by the C7 SP magnetic stimulation. However, SSR was successfully evoked by the T2 SP stimulation. CONCLUSION: We believe that the latency difference of C7 and T2 spinous process stimulation reflects the central conduction time of SSR.
Action Potentials ; Electric Stimulation ; Fingers ; Healthy Volunteers ; Humans ; Skin* ; Spinal Cord Injuries ; Spinal Nerve Roots ; Spine

OBJECTIVE: The diagnosis of myofascial pain syndrome (MPS) is commonly made by Simons' clinical diagnostic criteria which is mainly based on patients' complaints, so it is difficult to distinguish from malingering. The purpose of this study is to evaluate local twitch response by needling (LTR) as an objective diagnostic criterion of MPS. METHOD: Forty four industrial designers complaining of regional pain in neck, shoulder, or upper arm were examined by a physiatrist. If trigger point was detected, local twitch response by needling was confirmed and than severity was measured by 4 grades. Sensitivity, specificity, and positive predictive value of local twitch response was calculated with diagnosis made by Simons' clinical diagnostic criteria. Correlation between grade of local twitch response and sum of clinical features in Simons' criteria was also evaluated. RESULTS: Local twitch response by needling was corresponding with the diagnosis of MPS by Simons' criteria (sensitivity 100%, specificity 96.7%, positive predictive value 93.3%), and the severity of local twitch response was significantly associated with sum of clinical features in Simons' criteria (Spearman correlation 0.950; p=0.048) CONCLUSION: Local twitch response by needling is an important and objective diagnostic criterion of MPS.
Arm ; Diagnosis ; Malingering ; Myofascial Pain Syndromes* ; Neck ; Sensitivity and Specificity ; Shoulder ; Trigger Points

OBJECTIVE: This study was designed to measure the range of normal values of the diaphragmatic latency, central motor conduction time and the extent of right-left agreement after a magnetic stimulation and to measure the parameters of diaphragmatic activity after magnetic stimulation in stroke patients and to compare them with the results of pulmonary function test (PFT). METHOD: In seventeen healthy adults and sixteen well-cooperated stroke patients, a magnetic stimulation with 90 mm circular coil (Magstim 200) on cerebral cortex during inspiration and on C7 spinous process, and a transcutaneous electric stimulation of phrenic nerve were performed. An active electrode was attached at 5 cm superior to the tip of the xiphoid process, a reference electrode at chestwall along the midclavicular line at the lower margin of rib cage, and a ground electrode at sternum. Pulmonary function test was checked in the stroke patients. RESULTS: The latencies of magnetically evoked Compound muscle action potential (CMAP) were 15.1 ms on cortical stimulation, 7.7 ms on cervical stimulation and the central motor conduction time (CMCT) of diaphragm was 7.4 ms in a control group. Normal limits of each parameter were 17.7 ms, 8.9 ms and 9.8 ms in 95% CI and right-left difference of each parameter was not found. In stroke patients, twelve patients showed delayed CMCT or unevokable CMAP, and among them eleven patients showed restrictive pattern in PFT. Patients with delayed CMCT or unevokable CMAP had significantly high risk of restrictive pulmonary dysfunction. CONCLUSIONS: We measured the normal values of evoked response of the diaphragm for cortical and cervical stimulation. In stroke patients, those with delayed CMCT or unevokable CMAP for diaphragm showed higher incidence of restrictive pulmonary dysfunction. Motor evoked potentials of the diaphragm could be used to detect the respiratory dysfunction of central origin.
Action Potentials ; Adult ; Cerebral Cortex ; Diaphragm* ; Electrodes ; Evoked Potentials, Motor* ; Humans ; Incidence ; Phrenic Nerve ; Reference Values ; Respiratory Function Tests ; Ribs ; Sternum ; Stroke* ; Transcutaneous Electric Nerve Stimulation